Organization
PHARM NACOGDOCHES ACQUISITION LLC
Active
Other names
THE MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW FINN (OFFICER)
(469) 261-3048
Entity
Organization
Contact information
Practice address
212 NORTH ST STE B, NACOGDOCHES, TX 75961-5260
(936) 462-9101
Mailing address
212 NORTH ST STE B, NACOGDOCHES, TX 75961-5260
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
30632
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14380
—
TX
Enumeration date
04/24/2017
Last updated
06/29/2021
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